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Objective:To evaluate left ventricular systolic function and myocardial perfusion in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) by left ventricular pressure-strain loop (PSL).Methods:From August 2020 to December 2020, 47 patients with AMI admitted to the Intensive Care Unit of Cardiovascular Department of the First People′s Hospital of Foshan and treated with PCI were selected. Myocardial contrast echocardiography (MCE) and conventional echocardiography were performed within 72 hours after operation (T1 phase) and conventional echocardiography was repeated 3 months later (T2 phase). Myocardial perfusion scores (MPS) of left ventricular segments were obtained by MCE and the overall myocardial perfusion score index (PSI) was calculated. According to PSI, the patients were divided into good perfusion group and poor perfusion group. Conventional ultrasonic parameters and two-dimensional global longitudinal strain (2D-GLS) were collected. Left ventricular PSL analyzed in off-line EchoPAC software was used to evaluate the left ventricular myocardial work index, including global work index (GWI), global constructive work (GCW), global waste work (GWW), global work efficiency (GWE). The differences of parameters between patients with different perfusion levels and the change of parameters with time at the same perfusion level were compared. ROC curves were used to analyze the diagnostic values of strain parameters and myocardial work parameters in patients with hypoperfusion.Results:There were no significant differences in conventional ultrasound parameters between groups in T1 and T2 phases (all P>0.05), while there were significant differences in 2D-GLS and myocardial work parameters (except GWI in T2 phase) (all P<0.05). The absolute values of 2D-GLS and myocardial work parameters (except GWW ) were higher than those in T1 phase (all P<0.05). There was no significant difference in GWW ( P>0.05), but it decreased in good perfusion group while increased in poor perfusion group over time. ROC curve analysis showed that 2D-GLS, GWI, GCW and GWE had high area under the curve. Conclusions:Left ventricular PSL provides a new sensitive method for the evaluation of cardiac function in patients with AMI after PCI, and is expected to become a new index for the preliminary evaluation of microcirculation.
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Objective To explore the path of subjective well-being, perceived social support and professional commitment among undergraduate nursing students. Methods A total of 207 undergraduate nursing students in a medical university in Anhui were recruited by cross-sectional survey method. Nursing students were investigated using General Information Questionnaire, Index of Well-being, Perceived Social Support Scale, Professional Commitment Scale during October to November 2016. SPSS 16.0 was used for statistical analysis, the data were analyzed by t test or variance analysis;Multivariate analysis was performed by multiple linear regression, and AMOS 17.0 was used for mediation analysis. Results The professional commitment score for nursing students was (88.01 ±10.94); perceived social support and subjective well-being were positively correlated with professional commitment (r=0.349-0.413, P=0.000); nursing role, pro-fessional interest, perceived social support, subjective well-being can positively predict professional commit-ment (β=0.157, 0.324, 0.210, 0.220), motivation can negatively predict professional commitment;path analysis showed that perceived social support played a partial mediating role between subjective well-being and pro-fessional commitment. Conclusion The professional commitment were related to subjective well-being and perceived social support, and perceived social support plays a partial mediating role between subjective well-being and professional commitment among nursing students. Nursing educators can understand social support and subjective well-being as the breakthrough point, which actively formulate intervention strategies to enhance the professional commitment, stabilize the development of nursing team, and improve the quality of nursing.
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Objective To evaluated the value of myocardial perfusion before delayed percutaneous coronary intervention (PCI) for predicting the recovery of systolic function of patients with acute myocardial infarction (AMI).Methods A total of 64 patients with AMI receiving delayed PCI treatment in the First People's Hospital of Foshan from January 2014 to June 2015 were selected.One day prior to delayed PCI,all of the patients underwent two dimensional strain to measure the longitudinal peak systolic strain (LPSS) of each left ventricular segment and the global longitudinal strain (GLS) of the left ventricle.The myocardial perfusion score (MPS) and the perfusion score index (PSI) were measured by myocardial contrast echocardiography (MCE).Left ventricular myocardial perfusions were classified as good,reduced,or absent.The two dimensional strain measurements were again conducted at 6 months after the delayed PCI to assess LPSS and GLS.The change of GLS and LPSS between one day prior to delayed PCI and six months after delayed PCI was assessed by paired t-test.The differences of LPSS among good,reduced,or absent myocardial perfusion groups were analyzed by one-way ANOVA.LSD-t test was used to compare in pairs of groups that had different values.The correlations between PSI and GLS,MPS and LPSS were assessed by Spearman's rank-correlation test.Results The GLS of all patients were higher at six months after delayed PCI than at one day prior to delayed PCI [(-15.39±7.80)％ vs (-12.44±8.38)％,t=14.398,P ＜ 0.001].The LPSS of myocardial perfusion in good,reduced and absent groups at one day prior to delayed PCI were (-2.64±5.60)％,(-6.19±6.87)％ and (-12.07±5.86)％,respectively.The LPSS of myocardial perfusion in good,reduced and absent groups at six months after delayed PCI were (-2.97 ± 4.93)％,(-11.38± 7.26)％ and (-15.82 ± 5.97)％,respectively.The myocardial LPSS of left ventricular segment with good or reduced perfusion was significantly higher at six months after delayed PCI (t=13.013,10.821,both P ＜ 0.001),but the LPSS of left ventricular segment with absent perfusion was similar to that of pre-PCI.Whether at one day prior to delayed PCI or six months after delayed PCI,there were significant differences in LPSS parameters among the three groups (at one day prior to delayed PCI,myocardial perfusion absent vs reduced or good,t=4.201 and 11.771,both P ＜ 0.001;myocardial perfusion reduced vs good,t=12.561,P ＜ 0.001;at six months after delayed PCI,myocardial perfusion absent vs reduced or good,t=9.714 and 15.646,both P ＜ 0.001;myocardial perfusion reduced vs good,t=9.254,P ＜ 0.001).The LPSS both at one day prior to delayed PCI and six months after delayed PCI in myocardial perfusion good group ＞ those of myocardial perfusion reduced group ＞ those of myocardial perfusion absent group.PSI was positively correlated with GLS at both one day prior to delayed PCI and six months after delayed PCI (r=0.69,0.72,both P ＜ 0.001).MPS was positively correlated with LPSS at both one day prior to delayed PCI and six months after delayed PCI (r=0.49 and 0.45,both P ＜ 0.001).Conclusion Myocardial perfusion before delayed PCI,monitored by MCE,is correlated well with myocardial systolic function,and may be used to predict the recovery of myocardial systolic function after delayed PCI.
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Purpose To explore the predictive value of myocardial perfusion in assessing myocardial systolic function recovery after primary percutaneous coronary intervention (PPCI),in order to improve poor prognosis by early detection of myocardial no-reflow.Materials and Methods Forty nine patients with acute myocardial infarction (AMI) who had received PPCI were chosen as subjects.All the patients underwent two-dimensional strain (2DS) images and resting real-time myocardial contrast echocardiography (MCE) within one week after surgery,and 2DS measurement was repeated after three months.2DS imaging was used to acquire longitudinal peak systolic strain (LPSS) at all myocardial segments.Based on the graphs of LPSS,left ventricular myocardium was divided into normal contractile function myocardium (red) and impaired contractile function myocardium (light red,blue).According to the myocardial perfusion scores (MPS) qualitatively assessed by MCE visual interpretation,the myocardia with impaired systolic function were categorized into three groups with different perfusion level.The changes of LPSS within one week and three months after surgery (△ LPSS) among the three groups were analyzed.The correlation between MPS and LPSS within one week and three months after PPCI was also analyzed respectively.Results The △ LPSS increased significantly among the three groups with the improvement of myocardial perfusion level [(-5.78±6.23)％ vs.(-4.37±6.60)％ vs.(-1.21 ±4.77)％,all P＜0.05].The MPS measured one week after PPCI was both positively correlated with the LPSS detected within one week after surgery and that after three months (r=0.47,0.58,P＜0.001).The consistence of myocardial perfusion scores given by two evaluators was good (Kappa=0.785,P＜0.05).Conclusion The level of myocardial perfusion after PPCI in patients with AMI is closely related to regional myocardial systolic function,and the improvement of myocardial perfusion can forecast the recovery of regional systolic function.
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Objective To investigate the effects of taurine on rats with CCl4-induced portal hypertension; To discuss its mechanism of action. Methods CCl4 compound method was used to prepare portal hypertension rat models. Experimental rats were randomly divided into normal group, model group, positive medicine group and low-, medium- and high-dose taurine groups. Each medication group was given relevant medicine for gavage. After four-week treatment, biochemical analyzer was used to detect the contents of ALT, AST and TBIL;ELISA was used to detect the contents of CⅣ, PCⅢ, LN, HA and the level of HYP in serum;hemodynamic method was used to detect PVP, PVF, MAP and HR;nitrate reduction method was used to detect the contents of NO, chemical colorimetry was used to detect the activity of eNOS, hepatic tissue;the activity of SOD, GSH-Px and the content of MDA in hepatic tissue;HE staining was used to observe the histopathological changes of the hepatic tissue. Results Compared with the model group, the contents of ALT, AST and TBIL in serum in medium-and high-dose taurine groups decreased significantly (P<0.05, P<0.01);the contents of CⅣ, PCⅢ, HA and HYP in serum in medium-and high-dose taurine groups decreased significantly, and LN in high-dose taurine group decreased significantly (P<0.05, P<0.01);the PVP, PVF in medium- and high-dose taurine groups and the HR in high-dose taurine group decreased significantly (P<0.01), and the MAP in high-dose taurine group inecreased significantly (P<0.05); the content of NO in hepatic tissue of medium-and high-dose taurine groups increased significantly (P<0.05, P<0.01);the activity of eNOS and the content of cGMP in high-dose taurine group increased significantly (P<0.05); the activity of SOD, GSH-Px in hepatic tissue of medium- and high-dose taurine groups increased significantly and the content of MDA decreased significantly (P<0.05, P<0.01);the hepatic tissue histopath-ological changes of low-, medium-and high-dose taurine groups were significantly improved, especially the high-dose taurine group. Conclusion Taurine has inhibitory effects on rats with portal hypertension, which perhaps are related to its effects on enzyme activity inhibition and hepatic tissue protection, inhibiting the damage of oxidative stress, upregulating eNOS expression, enhancing the content of NO and improving liver function.
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Objective To explore the mediating role of coping modes between illness perception and posttraumatic growth among patients with breast cancer. Methods Totally 300 patients with breast cancer were investigated with the posttraumatic growth inventory, brief illness perception questionnaire and medical coping modes questionnaire. Results The total score of illness perception was 40. 77 ± 6. 85. The scores of confrontation coping style,avoidance coping style and resignation coping style were 19.42±3.51, 17.78±2.79,8.64±3.35. The total score of posttraumatic growth was 57.38±10.48. Illness perception was negatively correlated with posttraumatic growth ( r=-0.743) ,confrontation( r=-0.568) and avoidance ( r=-0.621),positively related with resignation( r=0.727).Posttraumatic growth was positively correlated with confrontation and avoidance ( r=0.729, r=0.657) ,but negatively correlated with resignation( r=-0.757) (P<0.01) . Coping modes had a partial mediating effect on the relationship between illness perception and postt?raumatic growth. The total mediation effect value was 0.428,and the mediation effect was 57.60%,while con?frontation and resignation mediation effect value were -0. 191 and -0. 207, and the mediation effect were 25.70% and 27. 86%. But there was no statistical significance in avoidance mediation ( effect value was-0.030 and the mediation effect was 4.04%) . Conclusion Confrontation and resignation coping modes play a role multiple mediation effects between illness perception and posttraumatic growth.
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Objective To investigate the teaching modes of the course of guide to learn in undergraduate nursing students in order to improve their quality of leaning.Methods Questionnaire survey and interview were conducted to collect the students'general appraisal on learning Science and teaching content and teaching modes as well as ingathering and suggestions of the course.Results Totally 79.5%among 117 students thought it necessary to open the course of Learning Science.96.6%students considered ten subjects of the course reasonable.83.8%students were satisfied with the alternate five-teachers'teaching modes.The most digestible teaching approach Was illustration,and the most valuable experience wag how to regulate the psyehology of learning.Conclusions The course of guide to learn in nursing undergraduate education has positive significance.Nursing educators should always explore and improve the teaching mode of this course so as to help students develop SOundly.